Effect of soft tissues manipulation on patients with chronic bronchitis

The purpose of this study: to determine the effectiveness of soft tissues manipulation on chronic bronchitis; diaphragmatic and thoracic excursion and patient's symptoms. Subjects and methods: 90 chronic bronchitis male patients with stable condition and under medications; they all were selected from Kafre El sheikh chest hospital. The ages of all participants ranged from 50 to 60 years, Patients were classified according to COPD severity index into two groups. Group (A) is the control group and was consist of 30 chronic bronchitis patients received a placebo treatment in form of light touch to the same anatomical regions and for the same time as study group. Group (B) is the study group and was consist of 60 chronic bronchitis patients with grade II (moderate) and III (severe) severity index, received a soft tissues manipulation treatment consist of four manual therapy techniques with the following sequence; rib raising, doming the diaphragm, sub occipital release and thoracic lymphatic pump, once weekly and for three consecutive weeks. Data measured include, chest expansion by measurement tape, diaphragmatic excursion evaluated by M.mode ultrasound and patient's symptoms guided by Guyatt's Chronic Respiratory Disease Questionnaire (GCRDQ), all were measured at baseline and half hour after the third treatment. Results: The results of this study demonstrated that application of soft tissues manipulation in form of rib raising, doming the diaphragm, sub occipital release and thoracic lymphatic pump in chronic bronchitis male patients with age ranging between 50 and 60 years old had a highly significant effect on chest expansion as it increased by (20.7%), diaphragmatic excursion increased by (22.25%) and patient's symptoms improved by (98.83%) for dyspnea (shortness of breath) and by (90.94%) for patient's emotional state. While application of placebo treatment in form of a light touch had no significant effect on chest expansion but had a highly significant effect on diaphragmatic excursion as it increased by (1.84%) and patient's symptoms improved by (24.72%) for dyspnea (shortness of breath) and by (33.21%) for patient's emotional state. Conclusion: It was concluded that chest expansion, diaphragmatic excursion, and patient's symptoms in patients with chronic bronchitis showed better response after application of soft tissues manipulation techniques than who received a placebo treatment.